Apparatus for artificial pneumothorax



March 3, 1931. J. R. HERRADORA 1,794,404

' APRARATUS FOR ARTIFICIAL PNEUMOTHORAX Filed April 28, 1927 PatentedMar. 3, 1931 PATENT OFFICE JUAN RAFAEL HERRADORA,

OF SEGAUCUS, NEW JERSEY APPARATUS FOR ARTIFICIAL PNEUMOTHORAXApplication filed April 28,

This invention relates to an apparatus for performing the operation ofartificial pneumothorax with filtered gases.

One of the objects of this invention is to improve such apparatus sothat it is self-setting at each operation for the performance of thefollowing operation.

Other objects are to improve the construction of such mechanism, so thatthe maintenance of absolutely sterile conditions is facilitated; and topermit the necessary actuation of the device with ease and certainty.

One form of execution of this invention is illustrated onthe accompanydrawings, in which:

Figure 1 is a front view of the apparatus. Figs. 2, 3 and 4 aresectional views through the control valve employed.

This apparatus for the operation of artificial pneumothorax is composedof two displacement vessels which are connected adjacent their bottomsfor the movement of the. displacement liquid. In the practice of theoperation, one of the vessels, being filled with displacement liquid, iselevated above the other, so that the liquid may run by gravity into thelower vessel and force the gas initially in the lower Vessel to passthrough conduits including a gas filter to the injecting needle. A valveis provided to control the flow of the gas When the operation has beencompleted y the injection of the desired quantity of gas, the remainingliquid in the upper bottle is ermitted to fiow into the lower one, witha ree escape of the air in the lower bottle. The positions of thebottles are then reversed so that the lower bottle (now filled withdisplacement liquid), is raised above the level of the bottle whichformerly was u permost; and the device is now ready for a urtherinjection of air by displacement from'the now upper to the now lowerbottle. This injection is supervised by the attendant by observing thescales located upon the bottles which-indicate the volume of gas whichhas been displaced, and the pressures prevailing in the pleural spacemay be supervised. at varying intervals by a manometer.

It will be understood that it is customary to perform this operationwith filtered air:

1927. Serial No. 187,180.

although any filtered gas having the proper medicalqualities may beused, and any such injection medium is comprehended b the term gas inthis specification and its c aims. The displacement liquid employed maybe 66 water, or any other suitable substance.

On the drawings, a stand 10 supports a table 11 having a guard back 12.A frame comprising the two vertical columns 13 and 14 which areconnected at the top is fastened to rigidly to the table and back. Aholder or sliding carriage 15 is located for movement along the column13 in a vertical direction and incudes a clamp member 16 which supportsa vessel 17 which preferably is of transparent material such as glass,and is provided with an indicating scale 18 at its front. A similarsliding carriage 19 with a clamp 20 is movable on the column 14 andsupports a similar vessel 21. Thesevessels are of the same size and ofabout 1500 cc. calibrated capacity each, the scales on each being markedfrom top to bottom and from bottom to top.

A sprocket 22 is journaled at the top of the frame and carries a chain23 which is connected at its respective ends to the two carriers 15 and19, so that when one vessel is raised, the other is lowered; and viceversa.

A conduit 21 is rigidly mounted upon the table by a supporting bracket24a; and is practically located between the columns 14,

14 for greater protection. Adjacent its top, this conduit is providedwith a three-way valve 25 which controls the passage through the conduit24 and a branch tube 26 which 95 leads to a monometer which is shown asa U-tube 27 rigidly fastened to the table and back and having the scales28 by which the position of the liquid column in the manometer may beread, whereby to determine the pressure existing at any moment in thepleural space. A flexible tube 29 is in communication with the dischargeconduit 24 at the lower end of the latter, and is provided with afiltering ampule 30 filled with a suit able filter material such asmedicated cotton to filter the gas passing through the tube 29 on itsway to the injection needle 31.

At its upper end, the discharge conduit 24 is provided with a furthervalve 41 and a cup 7 42, the latter being filled with a filteringmaterial similar to that employed in the ampule 30, for the purpose offiltering the gas or air prior to its entry into the respective vessel17, 21. The valve 41 is an automatic valve to control the connection ofthe respective vessels 17, 21 with the discharge conduit 24. As shown inFigs. 2 and 3, the valve casing 41 is provided with a plug 41a which hastwo passages 41b, 41c therein. The valve casing 41 likewise has its sidetubes 43, 44 which are connected respectively by the flexible tubes 34and 35 with the tops of the respective vessels 17, 21. This valve 41 isa four-way valve, and is competent of establishing communication asshown in Figs. 2 and 3. In the position of Fig. 2, the passage 417)places the cup 42 in communication with the tube 43 and tube 34 andthereby with the upper part of the vessel 17, so that air may fiow intothis vessel to fill it as the displacement liquid leaves it. The passage410 on the other hand places the upper part of the Vessel 21, by thetubes 35, 44, in communication with the discharge conduit 24 through thevalve 25. When the parts have been moved to the position shown in Fig.3, the upper part of the vessel 17 is placed in communication by itstube 34 and 43 with the discharge conduit 24: while the other vessel 21may receive air through its tubes 35, 44 from the cup 42.

This positioning of the valve body 41a is accomplished automaticallyduring the operation of raising and lowering the respective Vessels withtheir sliding carriages. The valve body 41a is provided with a handle 45which is pivoted at its free end to a slotted link 46. A pin 47 on thesliding carriage 15 is engaged permanently in the slot of the link 46.

The bottoms of the vessels are placed in communication with each otherby a flexible conduit 36 for the displacement liquid, so that the liquidis free to flow from one vessel to the other so long as there is adifference in level in the two vessels, and so long as an escape isprovided for the gas located at the top of the vessel having the lowerlevel.

A means is provided for lifting and lowering the respective bottleswhich is illustrated as comprising the cables 37 which extend downwardlythrough holes in the table 11, and are connected to the respectivepedals 38, 39 which are journaled on a cross-bar 40 of the stand 10.

The operation of the artificial pneumothroax may be accomplished withthis apparatus as follows:

When the bottles are in the position of Fig. 1, i. e., with the lefthand vessel 17 raised and containing substantially all of thedisplacement liquid,,and the right hand vessel 21 lowered and filledwith the gas to be injected, the valve body 410. being in the positionin Fig. 2, and with the three-way valve 25 presenting its valve body inthe position shown in dotted lines in Fig. 2, the attendant inserts theinjection needle 31 into the patients thorax. The three-way valve 25 isthen nuwed to the position shown in full lines in Fig. 2. Thedisplacement liquid in the vessel 17 now flows through the commondisplacement liquid conduit 36 into the vessel 21, and forces the gas tothe upper portion of this vessel to pass through the tubes 35 and 44,the passage 410, the valve body 25a, the discharge conduit 24, thefiltering ampule 30 and the flexible duct 29 to the injecting device 31.The pres-sure of the gas thus passing can be measured by the manometer27 by turning the valve 25a to a position such as shown in Fig. 3: whilethe pressure prevailing in the interpleural space may be determined bymoving the valve body 25a into the position shown in Fig. 4. The volumeof gas injected is determined bythe downward movement of thedisplacement liquid in the vessel 17 or the upward movement of thisliquid in the vessel 21 and may be read easily from the scales providedupon each of these bottles. When the attendant desires to discontinuethe injection, the valve body 25a may again be turned to the dotted lineposition and the injecting needle 31 withdrawn.

In order to reset the mechanism for a further operation, the valve 25 isagain opened to permit the escape of air from the vessel 21 until thedisplacement liquid has come to the same level in the two vessels 17 and21, being at the lowest graduation in the vessel 17 and at the highestgraduation in the vessel 21. The pedal 38 is then operated to raise thevessel 21 and lower the vessel 17. During the downward movement of thecarriage 15 with its vessel 17 the pin 47 slides freely in the slot ofthe link 46: when the pin finally encounters the bottom of this slot itdrops downward upon the link and moves the valve handle 45 so that thevalve body 41a is moved from the position of Fig. 2 to that shown inFig. 3. This movement occurs during the latter stage of the carriagemovements and causes the disconnection of the vessel which formerly wasdelivering gas to the conduit 24 and the reconnection of the othervessel, while at the same time connecting the vessel now full ofdisplacement liquid with the cup 42 so that it may draw in a furthersupply of gas for use during the next operation. With the substitutionof a sterile injecting needle 31 the device is again ready for service,for a new operation.

When this new operation has been completed, the pedal 39 is operated sothat the vessel 17 is restored to its uppermost position while thevessel 21 is lowered. During. the first part of the upward movement ofthe carriage 15, the pin 47 again moves freely manently contained in theapparatus and at in the slotted link 46, but toward the close of thismovement it encounters the end of the slot and moves the link 46'upwardly, to move the handle of the valve body 41a back into theposition shown in Fig. 1, thereby reestablishing the former connectionsof the vessels 17 and 21 with the atmosphere and with the discharge tube24, respectively.

It will be seen that the device is very simple and automatic in itsfunctions: and that the delivering of gas for one operation ofartificial pneumothorax causes the substantial resetting of theapparatus for the succeeding operation, and that the various parts maybe maintained clean. The use of the pedals avoids the necessity ofcontact even with the gloved hand, and the three-way valve 25 may beoperated and handled by a sterile clip, thereby giving the surgeonsufii'cient opportunity to keep his gloves out of contact with aninstrument that is not bacteriologically sterile or aseptic: while atthe same time the portions of the apparatus which are in contact withair or gas may be maintained clean: and the gas itself filtered on itsway to service.

The manometer 27 has its scale 28 divided into sections with a zero linesubstantially midway of each scale. The readings may be taken on eitherarm, and it is preferred to designate the readings above and below thezero line as plus or positive and minus or negative, respectively, onthe left hand arm, while the readings on the right hand arm are ofcourse reverse. These scales are divided according to any desirablestandard as for example, in pounds per square inch or kilos per squarecentimeter, or in terms of inches of mercury or water of according toany other accepted standard for such measure.

The manometer 27 is preferably placed in communication with theinterpleural space of the patient at varying intervals during theoperation by turning the valve 25 to the position shown in Fig. 4, sothat the absolute pressure prevailing in the space may be determined.

It is obvious that the invention is not limited to the specific formsillustrated and described, but that it may be modified within the scopeof the appended claims.

I claim: I

1. In a gas injecting apparatus, a support, two vessels, a liquidconduit connecting the bottoms of said vessels so that a liquid perahigher level in one vessel may flow through said conduit to establish auniform level 1n said vessel, a four-way valve on said support,

a discharge conduits for connecting the tops of the vessels with saidvalve, a pair of vertical slide-ways fixed on said support,.carriagesmovable on said slide-ways for holding said vessels upright whilepermitting them to be raised and lowered with said carriages on saidslide-ways, means for connecting said carriages so that one is raised asthe other is lowered, an injection conduit leading from said four-wayvalve to the injecting device, a gas inlet means for said valve, andmeans operated by the movement of the said carriages to actuate saidvalve to connect one of said discharge conduits to said gas inlet means.

2. An apparatus as in claim 1, in which said connecting means comprisesa pulley mounted on said support and a chainpassing over said pulley andconnected at its ends to said carriages.

In testimony whereof, I afl'ix my signature.

JUAN RAFAEL HERR-ADORA.

